Organization
LSH EXPRESS INC
Active
Other names
EXPRESS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RUBEN FATAKHOV (PRESIDENT)
(718) 997-7444
Entity
Organization
Contact information
Practice address
9914 63RD RD, REGO PARK, NY 11374-1940
(718) 997-7444
(718) 997-7445
Mailing address
9914 63RD RD, REGO PARK, NY 11374-1940
(718) 997-7444
(718) 997-7445
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
030750
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5802942
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/20/2011
Last updated
12/13/2011
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